BioEdge is back—almost

Dear readers, 

A very Happy New Year to you! Unfortunately our editor, Michael Cook, is ill this week. We will be back again next week with a full edition of BioEdge. 

Best wishes, 

Xavier Symons

Deputy Editor 

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Happy Christmas! Happy New Year!

The staff of BioEdge will be taking a break as of next week until mid-January. All the best to our subscribers and their families for a Merry Christmas and Happy New Year. If you have any ideas for articles or for improving the website, please let us know. Cheers,

Michael Cook

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Science under Xi Jinping

It’s hard enough for doctors and scientists to resist the allure of profit in a democratic society, as an article below about Australian cosmetic surgery demonstrates. But when science becomes an arm of government propaganda, the pressures must be immense.

The picture is still cloudy, but the Chinese scientist who edited the genome of two babies, He Jiankui, seems to have succumbed. According to a Chinese bioethicist working in New Zealand (see article below), he was a dazzling star who was reaching the “commanding heights”, as President Xi Jinping had exhorted Chinese scientists to do earlier this year in a major policy speech.

Xinhuanet, the official newsagency, reported that Xi told scientists and engineers to have the “courage to explore the uncharted courses and realize the goal that key and core technologies are self-developed and controllable.”

Now He, having embarrassed the government over the questionable ethical standards of his work, has disappeared. He may be in jail. This must surely send mixed message to his colleagues. Be ethical and obscure. Or see what you can get away with and become gloriously rich.

It must be hard to be a scientist in today’s China.

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He did it

Many scientists were aghast this week when a Chinese expert in CRISPR, He Jiankui, announced the birth of gene-edited twins – probably the world’s first “designer babies”.  

Dr He is being described as a “rogue scientist” who ignored the rules. But that is the way that whole field of reproductive technology has advanced. Bob Edwards, who won the Nobel Prize in Medicine for developing IVF, never sought ethics approvals or worried about the safety of the children.

In fact, he was an unashamed eugenicist. As Edwards said in 1999: “Soon it will be a sin for parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children.” Edwards did not even seem to worry about the higher rate of birth defects among IVF children. They were just collateral damage of the “clinical imperative”.

Yet now Bob Edwards is regarded as a hero -- because his risky experiment worked. 

I think that it is a bit unfair to label Dr He as a rogue. In fact, his robe-tearing, scandalised colleagues agree that editing the human genome is ethical. They are just worried that he did not tick all the boxes and do all the paperwork. This is very bad public relations for them and for the Chinese government.

In fact, given the deteriorating place of human rights in China at the moment, He Jiankui will be lucky to escape a long prison term -- or even execution – to regild the government’s tarnished image as a watchdog of uber-ethical science.

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The Nature of transgender

With people as wise as former US Vice-President Joe Biden asserting that transgender equality is the “civil rights issue of our time”, it’s no surprise that the world’s leading science journal agrees. In a scathing editorial late last month Nature argued that the Trump Administration’s “proposal for defining gender has no basis in science”.

There is no doubt that many bioethicists would agree with Mr Biden. In fact, a psychotherapist raised a storm in the British media this week with his interpretation of the crisis. It’s just that he took a view 180 degrees opposed to Nature. “In 20 years’ time, I believe we will look back on this folly as one of the darkest periods in the history of modern medicine,” wrote Bob Withers.

Despite trans Twitterstorms twisting and weaving their way across the bioethical landscape, it seems that the science and ethics of transgender issues is far from settled. It’s worthwhile listening to both sides of the debate. 

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Celebrating the reproductive revolution

Occasionally we tag one of our articles “reproductive revolution” because it exemplifies how far law and technology take us once sex has been detached from reproduction. This week’s tale comes from India. A team at Galaxy Care Hospital in Pune has performed India’s first successful uterus transplant. A 45-year-old mother donated her womb to her 28-year-old daughter who eventually gave birth to a healthy baby girl.

Arrangements like this are no longer newsworthy, but what made the transplant necessary? It turns out that the young woman had had at least two abortions and these had damaged her uterus. Frankly, I find this fertility-at-any-cost approach a bit bizarre.

But not more bizarre than some of the other stories: the Dutch sperm donor who may have fathered 1000 children, the Japanese man who is raising 13 children by commercial surrogates from Thailand, the 65-year-old German grandmother who gave birth to quads, the German zoophile who is in a “relationship” with his Alsatian because “Animals are much easier to understand than women” and so on.

The reproductive revolution was originally intended to give loving couples the joy of having children of their own. How differently it has turned out. As they say, “Like Saturn, the Revolution devours its children."

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Michelle Obama’s IVF kids

As sometimes happens, most of our stories this week centre on assisted suicide and euthanasia in various jurisdictions. However, our lead story is about Michelle Obama's revealing memoir, Becoming, which will be released this week around the world. In various pre-publication interviews the former First Lady discloses that after she had a miscarriage she and her husband resorted to IVF to have their two daughters Malia and Sasha. 

When she was about 34, she realized that "the biological clock is real" and that "egg production is limited". "I think it's the worst thing that we do to each other as women, not share the truth about our bodies and how they work," she told Good Morning America. Perhaps her advice will prompt young women to try to have their children earlier. Somehow the message just doesn't get through: women can't have children whenever they want. Fertile women who delay having a family are probably the best clients of the IVF industry. 

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Normalising assisted suicide

It happened so long ago that the exact details are dim in my mind, but I seem to remember that a nominee for the US Supreme Court nearly failed to score his dream job because of an alleged crime of attempted rape when he was a 17-year-old high school student. There was a huge controversy, wasn’t there? Demonstrations, twitterstorms, talking heads across the nation in a frenzy, politicians grandstanding...

Of course times were different way back then and public figures were held to a higher moral and legal standard. As the saying goes, "The past is a foreign country; they do things differently there." Nonetheless it is disturbing to read that the Democratic candidate for the governor of California, Gavin Newsom, casually told a journalist for The New Yorker that he assisted his mother to commit suicide in 2002. Assisting a suicide was a crime in California in 2002– and it still is if you are not a doctor. And at the time Newsom was not a callow teenager, but a member of the San Francisco Board of Supervisors.

The odd thing about this is that there has been almost no reaction. Assisting a suicide is just as much a crime as attempted rape and in this case Newsom has admitted that he did it. You would think that at least his Republican opponent would seize upon this blithe admission as a golden opportunity to knock off Newsom's Kennedy-esque halo.

But no one seems to care. What more do you need to show that assisted suicide has been normalised in California?

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Transhumanist dreams

I don’t know whether it is due to reading too much science fiction or not reading enough, but I find it impossible to take the transhumanist movement seriously. Some of its ideas about self-definition have seeped into mainstream culture, like transgenderism. However, its vision of a future in which homo sapiens has evolved into Morlocks and Eloi (as H.G. Wells foresaw in The Time Machine) seems almost preposterous, at least to me.

Perhaps to allay fears that scepticism from people like me will eventually lead to injustice against the more advanced sort of people, American transhumanists have drafted a transhumanist Bill of Rights (see below). This guarantees “sentient entities” everything from universal health care and internet coverage to “self-consciousness in perpetuity”.

One thing that I can never quite grasp about the earnest predictions of transhumanists is whether they actually care whether their schemes are practical. Uploading one’s consciousness to the internet sounds super but the obstacles in its path are more like the Himalayas than parking lot speedbumps – apart from all the ethical issues. Anyhow, good luck to them!

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Bioethics and American politics

The leading bioethics issue in American politics is, by far, abortion. But others have made an impact. The proper use of human embryonic stem cells was debated in Obama’s first campaign. Euthanasia is sure to become an issue at some stage. But, much to my surprise, consumer genetics is emerging as a sleeper issue.

Millions of Americans have used the services of direct-to-consumer genetic ancestry testing companies. Now Senator Elizabeth Warrane, aka “Pocahontas” to supporters of President Trump, has resorted to one to settle the controversial question of her Native American heritage. A report has finally demonstrated that she may have had a Native American ancestor six to ten generations ago. But it does not demonstrate that this ancestor was from the Cherokee tribe, or even from a tribe in the United States. 

Settling questions of personal identity with genetics is fraught with uncertainty. It’s an area that politicians – and everyone else -- should approach with great caution.

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